Blood transfusion
Facility: Salina Regional Health Center
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $1,004
- Cash Discount Price: $781
- vs. Medicare Baseline: 2.23x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $450.73 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 223% of the Medicare baseline (a markup of 123%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $540 - $568 | 120% |
| Preferred Phsic | $670 | 149% |
| Preferred Healthcare - All Other Plans | $904 | 201% |
| Cigna | $1,004 | 223% |
| Providers Care (Wppa)-All Plans | $1,004 | 223% |
| Aetna | $1,004 | 223% |
| Multiplan (Mpi)-All Plans | $1,004 | 223% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Salina Regional Health Center in Salina, KS, the facility's cash median price is $781.00, which is lower than the state average of $904.00. While the facility's negotiated rates with commercial payers average $1,004.00, this amount exceeds the cash price, meaning patients with high-deductible plans or those without insurance could save money by paying the cash rate directly. It is important to note that commercial payers like Blue Cross Blue Shield and Aetna have negotiated rates ranging from $540 to $1,004 depending on the specific plan, but these rates often include administrative overhead and may not reflect the lowest possible cost for the patient.
When reviewing your bill, ensure you request an itemized statement to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. If you are paying out-of-pocket, ask the billing department about prompt-pay discounts, which can reduce the total by 20% to 50% if settled within 30 days. Additionally, compare the facility's Medicare benchmark rate of $450.73 against your commercial negotiated rate; while commercial rates often average 200% to 300% of Medicare, fair pricing is typically defined as 120% to 150%, so you may be able to negotiate a lower rate if the facility's charges significantly exceed this range.